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Posts in "Medicaid"
September 30, 2014
Many states provide Medicaid managed care plans and the states give the plans wide leeway when it comes to supervising standards for access to health care services. The bulk of persons enrolled in state Medicaid programs are covered by some kind of managed care program. The Department of Health and Human Services Inspector General, in a report on Monday, surveyed the diversity of state approaches to regulating managed care programs.
States allow different types of managed care options, which typically limit patients to a network of medical providers, but the states also provide varying levels of supervision. The inspector general found different standards for access to care and differing levels of effort in identifying violations. Federal supervision of the state Medicaid managed care plans is limited and the National Association of Medicaid Directors last week offered some suggestions to federal officials on improved federal and state supervision of the plans.
September 25, 2014
An objective of the health care overhaul’s provisions allowing states to expand coverage offered through the Medicaid program is the reduction in the burden on hospitals treating uninsured patients and the resulting hospital write-offs for uncompensated care. Hospitals are now beginning to recoup some the cost of treatment of previously uninsured patients through Medicaid, especially in states that have expanded the qualifications for Medicaid coverage.
The Department of Health and Human Services on Wednesday detailed the savings impact on hospitals, noting $4.2 billion in savings in states that have expanded the Medicaid program and $1.5 billion in states that have avoided an expansion. The federal government will pick up all of the expanded Medicaid program costs through 2016 and phase down to 90 percent of costs in 2020.
CQ HealthBeat’s (@CQHealthTweet) Rebecca Adams reported that the authors of the law expected a decline in charity care and bad debt as consumers gained insurance coverage. That was also one of reasons why Congress included in the health law billions of dollars in cuts in Medicare and Medicaid payments for hospitals that care for a large share of low-income patients. Additionally, the Affordable Care Act added requirements on charitable hospitals to document and justify policies and limit charges for uncompensated care.
September 23, 2014
Doctors have long-held a prominent lobbying role in Congress. Most of the focus of recent efforts by physician groups revolves around pressing to continue temporary adjustments to several Medicare and Medicaid payment formulas.
In November, members of a physician group are planning visits to lawmakers on Capitol Hill to urge an extension — beyond the scheduled year-end expiration — of a temporary Medicaid payment boost for primary care doctors. The payment increase was an attempt to reduce the gap between Medicaid and Medicare payment levels. The administration, earlier this month in its stopgap spending bill request, urged lawmakers to extend the primary care payments. But the adopted continuing resolution ignored the White House suggestion. CQ HealthBeat’s (@CQHealthTweet) Rebecca Adams reports on plans for the physician visits organized by the American Congress of Obstetricians and Gynecologists.
Also looming on the congressional agenda is the renewal of extended relief from planned cuts slated for next year to the broader Medicare physician payment formula. Congress has acted to thwart a scheduled physician payment cut each year for more than a decade. CQ Roll Call’s Melissa Attias reports that some lawmakers hope to permanently fix the payment formula during this year’s lame duck session. However, a permanent fix has long been a bipartisan objective but has been thwarted by disagreement on how to pay for the payment formula adjustment.
September 22, 2014
Over the next several weeks, 95 percent of people who signed up last year for a health plan through the federal insurance website, healthcare.gov, will be notified that their insurance will automatically renew for 2015. Earlier this year, the Department of Health and Human Service announced the process for the auto-renewal of policies.
However, people who signed up for a Medicaid plan may not know that they must take action to renew their coverage. CQ HealthBeat’s (@CQHealthTweet) Rebecca Adams reports that Medicaid recipients must reapply for coverage, even if their personal circumstances have not changed. The Medicaid program, which is largely administered by the states, requires each state to explain the renewal process. The varying state processes and accompanied documentation could result in some people losing coverage.
August 12, 2014
Medicare identification cards would no longer display beneficiaries’ Social Security numbers under a new bill outlined recently by the chairman of the House Ways and Means Subcommittee on Health. Rep. Kevin Brady, R-Texas, released the draft text of a measure that compiles a wide range of suggestions to thwart Medicare and Medicaid payment fraud and abuse. The proposals– collected from a bipartisan suggestions offered by committee members — range from halting payments for health services provided to deceased beneficiaries to enhanced fraud abuse monitoring of various specific provider payments, such as those for medical equipment, vacuum erection systems and ambulance services.
The aim of ending the printing of Social Security numbers on Medicare cards is to protect against possible fraud against Medicare beneficiaries, rather than to save the program’s money. The Medicare card is one of the few remaining federal documents that still display the full Social Security number, opening up the possibility for identity theft if the card is lost or stolen.
Eliminating Social Security numbers on the card is a long-running bipartisan congressional objective that has not been taken up by the Centers for Medicare and Medicaid Services. HealthBeat’s John Reichard reported in April on questions about the ID card posed to CMS official at a panel hearing on Medicare fraud. The Medicare agency insists that it lacks the resources to make the change.
The Government Accountability Office in 2012 reviewed several options offered to CMS to change the Medicare card. The suggestions included replacing the number, only partially displaying it, or denoting it in a machine readable bar code.
July 31, 2014
A Government Accountability Office report released on Tuesday examines states’ increasing reliance on taxes on health care providers to help cover Medicaid spending.
July 30, 2014
July 18, 2014
The Medicaid program, which is managed by the states with federal funding, has always had a wide variation of coverage. Various demographic and political factors have set the different state programs apart. The Government Accountability Office this week released a review of Medicaid enrollee spending differences between the states.
July 17, 2014
One of the most widely accepted expectations of both proponents and opponents of the 2010 health care law was that health care utilization rates would increase as newly insured persons sought treatment options. However, a report this week from the Robert Wood Johnson Foundation and Athena Health Research does not show a deluge in new patients.
July 16, 2014
A House Energy and Commerce panel today examines the income verification process for health plan premium subsidies. Problems with the verification system became apparent in news reports published in May and the committee is mulling recent reports from the Department of Health and Human Services inspector general on problems with early planning and insufficient controls on the troubled subsidy verification process. Full story
July 11, 2014
July 10, 2014
The agencies of the Department of Health and Human Services are prolific in offering health care funding and research grant opportunities. In the wake of additional batch of health center teaching grants earlier this week, HHS on Tuesday announced $100 million in funding for 150 new health center sites.